后腹腔镜与开放性去顶术治疗单纯性肾囊肿的对比研究

Comparative study on retroperitoneal laparoscopy and open surgical unroofing in the treatment of simple renal cysts

目的比较和评价单纯性肾囊肿后腹腔镜去顶术和开放性去顶术的治疗效果。方法76例单纯性肾囊肿者中采用后腹腔镜去顶术36例,开放性去顶术30例。对两种术式的临床疗效、术后恢复等进行对比研究。结果后腹腔镜组腰痛消失者91.6%(33/36),开放手术组腰痛消失者93.3%(28/30),两组比较差别无显著性意义(P>0.05)。两种手术方式均能达到良好的肾囊肿去顶效果,后腹腔镜手术在术中出血,术后下床活动时间,术后镇痛药使用情况,留置导尿管和引流管的时间,禁食时间,术后住院时间方面优于开放性手术(P<0.01)。结论后腹腔镜肾囊肿去顶术与开放性肾囊肿去顶术相比,疗效相似,但是前者创伤小、痛苦少、恢复快、并发症少。尽管目前后腹腔镜手术的直接费用较高,但能节约患者的住院时间,使间接费用降低。

Objective：To evaluate the effect of retroperitoneal laparoseopic and open surgical unroofing on simple renal cysts. Methods：Among 76 patients with simple renal cysts,36 received the retropcritoneal laparoscopic unroofing, 30 received the open surgery unroofing. The therapeutic effect ,the postoperative recovery of patients with different methods were compared. Results： Among 36 patients in the laparoscopic group, 33 patients＇ pain of back disappeared（91.6%）, and in the open surgical group 30 patients＇ pain of back disappeared （93.3%）（P〉 0.05）. Both methods could get better result in removing simple renal cyst. The intraoperative bleeding volume,the postoperative activity out of bed day,the indwelling urinary catheter and drainage tube time,the fasting time,the analgetic used postoperation,the postoperative hospital stay of the retroperitoneal laparoscopy method were better than those of open surgery （P〈0.01）. Conclusion： Retroperitoneal laparoseopic unroofing of simple renal cysts show similar therapeutic effect as open surgical unroofing,yet has quick recovery, less suffering and complications. Although the direct expenditure of retroperitoneal laparoscopy is higher than that of open surgey,its shorter hospitalization and less indirect expendi- ture promote its further popularization.